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Gastroesophageal reflux disease (GERD): causes
Alexey Portnov, medical expert
Last reviewed: 23.04.2024
Last reviewed: 23.04.2024
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Causes of gastroesophageal reflux disease:
Development of hypotension of the lower esophageal sphincter is facilitated by the following factors:
- consumption of products containing caffeine (coffee, tea, coca-cola), as well as medicines containing caffeine (citramone, cofetamine, etc.);
- ingestion of peppermint;
- taking medications that lower the tone of the lower esophageal sphincter (calcium antagonists, papaverine, no-sph, nitrates, baralgin, anticholinergics, analgesics, theophylline, doxycycline);
- defeat of the vagus nerve (vagal neuropathy in diabetes mellitus, vagotomy);
- smoking (nicotine reliably lowers the tone of the lower esophageal sphincter);
- the use of alcohol (thus not only lowering the tone of the lower esophageal sphincter, but also the damaging effect of alcohol on the mucosa of the esophagus and the sphincter itself);
- pregnancy (hypotension of the lower esophageal sphincter in this case is due to the influence of hormonal factors - high estrogenemia and progesteronemia, it also has significance in the development of GERD and an increase in intra-abdominal pressure during pregnancy).
- Violation of the function of the lower esophageal sphincter (lack of cardia), reduced esophageal clearance, damaging properties of refluxate (hydrochloric acid, pepsin, bile acids), inability of the mucosa of the esophagus to withstand the damaging effect.
- Violation of the function of the lower esophageal sphincter may be a consequence of the primary defect of the smooth muscles of the sphincter, hernia of the esophageal opening of the diaphragm.
- Other causes of cardia deficiency include scleroderma, pregnancy, smoking, use of drugs that reduce the tone of smooth muscles (nitrates, calcium channel blockers, euphyllin).
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